急诊医学学员在猪模型上进行股骨脉冲超声评估的准确性。

Darron K Fritz, Brandon M Carius, Mohamad A Umar, Lance W Camacho, Erin R Hanlin, Ryan A Curtis
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引用次数: 0

摘要

急诊超声(POCUS)越来越多地应用于急诊医学(EM),包括急诊住院医师和急诊医师助理(EMPA)住院医师。很少有文献评估该组在心脏复苏期间POCUS脉搏评估的准确性和持续时间,并给出了胸外按压最小停顿的建议。EM受训人员在使用POCUS时,需要评估脉冲解释的准确性和持续时间。方法:采用猪模型对EM临床实习医师进行脉冲POCUS评估的双盲观察研究。志愿者对5只被随机分为死亡或活着的猪模型的心脏状态不知情,并使用彩色多普勒POCUS对其进行股动脉评估。主要观察指标为脉搏评估的准确性。次要结果包括语言表达时间和基于报告的EM训练持续时间、超声经验和心脏骤停复苏经验的差异。结果:17名EM和EMPA学员共完成85次POCUS脉搏评估,准确率为98.82% (n=84)。平均言语化时间为6.95秒,大多数言语化解释在10秒内(82.4%,n=70)。这在活着的和死去的模型之间是大体一致的。亚组分析发现,根据报告的人口统计数据,准确性或言语化时间没有显着差异。结论:EM临床实习生对股动脉脉搏评估的言语解释具有较高的准确性和较低的平均时间,大多数在推荐的时间指南内。需要进一步研究将这些发现与人类患者联系起来。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Femoral Pulse Ultrasound Assessment Accuracy by Emergency Medicine Trainees on a Porcine Model.

of care ultrasound (POCUS) is increasingly used in emergency medicine (EM), including EM physician residents and EM physician assistant (EMPA) residents. Scant literature assesses accuracy and duration of POCUS pulse assessment by this group during cardiac resuscitation given recommendations for minimal pauses in chest compressions. Evaluation is needed for accuracy and duration of pulse interpretation in EM trainees utilizing POCUS.

Methods: We conducted a double-blind observational study of EM clinician trainee POCUS assessment of pulses using porcine models. Volunteers were blinded to the cardiac status of 5 porcine models randomized as deceased or living and performed femoral artery evaluation using color power Doppler POCUS. The primary outcome was accuracy of pulse assessment. Secondary outcomes included time to verbalization and differences based on reported duration of EM training, experience with ultrasound, and cardiac arrest resuscitation experience.

Results: 17 EM and EMPA trainees completed 85 total POCUS pulse assessments with 98.82% accuracy (n=84). Mean verbalization time was 6.95 seconds, and most verbalized interpretations were within 10-seconds (82.4%, n=70). This was grossly consistent between living and deceased models. Subgroup analysis found no significant differences of accuracy or verbalization time based on reported demographics.

Conclusion: EM clinician trainees demonstrate a high degree of accuracy and low average time for verbalized interpretation of femoral artery pulse assessment, most within recommended time guidelines. Further study is needed to correlate these findings in human patients.

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